Assessment of fatigability in patients with spinal muscular atrophy: development and content validity of a set of endurance tests

Abstract Background Fatigability has emerged as an important dimension of physical impairment in patients with Spinal Muscular Atrophy (SMA). At present reliable and valid outcome measures for both mildly and severely affected patients are lacking. Therefore the primary aim of this study is the deve...

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Main Authors: Bart Bartels, Laura E. Habets, Marloes Stam, Renske I. Wadman, Camiel A. Wijngaarde, Marja A. G. C. Schoenmakers, Tim Takken, Erik H.J. Hulzebos, W. Ludo van der Pol, Janke F. de Groot
Format: Article
Language:English
Published: BMC 2019-02-01
Series:BMC Neurology
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12883-019-1244-3
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author Bart Bartels
Laura E. Habets
Marloes Stam
Renske I. Wadman
Camiel A. Wijngaarde
Marja A. G. C. Schoenmakers
Tim Takken
Erik H.J. Hulzebos
W. Ludo van der Pol
Janke F. de Groot
author_facet Bart Bartels
Laura E. Habets
Marloes Stam
Renske I. Wadman
Camiel A. Wijngaarde
Marja A. G. C. Schoenmakers
Tim Takken
Erik H.J. Hulzebos
W. Ludo van der Pol
Janke F. de Groot
author_sort Bart Bartels
collection DOAJ
description Abstract Background Fatigability has emerged as an important dimension of physical impairment in patients with Spinal Muscular Atrophy (SMA). At present reliable and valid outcome measures for both mildly and severely affected patients are lacking. Therefore the primary aim of this study is the development of clinical outcome measures for fatigability in patients with SMA across the range of severity. Methods We developed a set of endurance tests using five methodological steps as recommended by the ‘COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). In this iterative process, data from multiple sources were triangulated including a scoping review of scientific literature, input from a scientific and clinical multidisciplinary expert panel and three pilot studies including healthy persons (N = 9), paediatric patients with chronic disorders (N = 10) and patients with SMA (N = 15). Results Fatigability in SMA was operationalised as the decline in physical performance. The following test criteria were established; one method of testing for patients with SMA type 2–4, a set of outcome measures that mimic daily life activities, a submaximal test protocol of repetitive activities over a longer period; external regulation of pace. The scoping review did not generate suitable outcome measures. We therefore adapted the Endurance Shuttle Walk Test for ambulatory patients and developed the Endurance Shuttle Box and Block Test and the - Nine Hole Peg Test for fatigability testing of proximal and distal arm function. Content validity was established through input from experts and patients. Pilot testing showed that the set of endurance tests are comprehensible, feasible and meet all predefined test criteria. Conclusions The development of this comprehensive set of endurance tests is a pivotal step to address fatigability in patients with SMA.
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spelling doaj.art-17ef6173ffbd46d892a08f0e858c2d0b2022-12-22T01:56:07ZengBMCBMC Neurology1471-23772019-02-0119111010.1186/s12883-019-1244-3Assessment of fatigability in patients with spinal muscular atrophy: development and content validity of a set of endurance testsBart Bartels0Laura E. Habets1Marloes Stam2Renske I. Wadman3Camiel A. Wijngaarde4Marja A. G. C. Schoenmakers5Tim Takken6Erik H.J. Hulzebos7W. Ludo van der Pol8Janke F. de Groot9Child Development and Exercise Center, Wilhelmina Children’s Hospital, University Medical Center UtrechtChild Development and Exercise Center, Wilhelmina Children’s Hospital, University Medical Center UtrechtDepartment of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center UtrechtDepartment of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center UtrechtDepartment of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center UtrechtChild Development and Exercise Center, Wilhelmina Children’s Hospital, University Medical Center UtrechtChild Development and Exercise Center, Wilhelmina Children’s Hospital, University Medical Center UtrechtChild Development and Exercise Center, Wilhelmina Children’s Hospital, University Medical Center UtrechtDepartment of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center UtrechtChild Development and Exercise Center, Wilhelmina Children’s Hospital, University Medical Center UtrechtAbstract Background Fatigability has emerged as an important dimension of physical impairment in patients with Spinal Muscular Atrophy (SMA). At present reliable and valid outcome measures for both mildly and severely affected patients are lacking. Therefore the primary aim of this study is the development of clinical outcome measures for fatigability in patients with SMA across the range of severity. Methods We developed a set of endurance tests using five methodological steps as recommended by the ‘COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). In this iterative process, data from multiple sources were triangulated including a scoping review of scientific literature, input from a scientific and clinical multidisciplinary expert panel and three pilot studies including healthy persons (N = 9), paediatric patients with chronic disorders (N = 10) and patients with SMA (N = 15). Results Fatigability in SMA was operationalised as the decline in physical performance. The following test criteria were established; one method of testing for patients with SMA type 2–4, a set of outcome measures that mimic daily life activities, a submaximal test protocol of repetitive activities over a longer period; external regulation of pace. The scoping review did not generate suitable outcome measures. We therefore adapted the Endurance Shuttle Walk Test for ambulatory patients and developed the Endurance Shuttle Box and Block Test and the - Nine Hole Peg Test for fatigability testing of proximal and distal arm function. Content validity was established through input from experts and patients. Pilot testing showed that the set of endurance tests are comprehensible, feasible and meet all predefined test criteria. Conclusions The development of this comprehensive set of endurance tests is a pivotal step to address fatigability in patients with SMA.http://link.springer.com/article/10.1186/s12883-019-1244-3Spinal muscular atrophyFatigabilityEnduranceOutcome measure
spellingShingle Bart Bartels
Laura E. Habets
Marloes Stam
Renske I. Wadman
Camiel A. Wijngaarde
Marja A. G. C. Schoenmakers
Tim Takken
Erik H.J. Hulzebos
W. Ludo van der Pol
Janke F. de Groot
Assessment of fatigability in patients with spinal muscular atrophy: development and content validity of a set of endurance tests
BMC Neurology
Spinal muscular atrophy
Fatigability
Endurance
Outcome measure
title Assessment of fatigability in patients with spinal muscular atrophy: development and content validity of a set of endurance tests
title_full Assessment of fatigability in patients with spinal muscular atrophy: development and content validity of a set of endurance tests
title_fullStr Assessment of fatigability in patients with spinal muscular atrophy: development and content validity of a set of endurance tests
title_full_unstemmed Assessment of fatigability in patients with spinal muscular atrophy: development and content validity of a set of endurance tests
title_short Assessment of fatigability in patients with spinal muscular atrophy: development and content validity of a set of endurance tests
title_sort assessment of fatigability in patients with spinal muscular atrophy development and content validity of a set of endurance tests
topic Spinal muscular atrophy
Fatigability
Endurance
Outcome measure
url http://link.springer.com/article/10.1186/s12883-019-1244-3
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